H1N1 Tied to Death, Serious Illness in Transplant Patients

But early treatment with antivirals associated with reduced rate of ICU admissions

By Beth Gilbert

HealthDay Reporter

FRIDAY, July 9 (HealthDay News) -- Influenza A H1N1 can cause substantial morbidity and mortality in solid organ transplant recipients; however, initiation of antiviral therapy within 48 hours of symptom development may decrease intensive care unit (ICU) admissions, according to a study published online July 9 in the The Lancet: Infectious Diseases.

In a multi-center cohort study, Deepali Kumar, M.D., of the University of Alberta in Edmonton, Canada, and colleagues evaluated 154 adults and 83 children from 26 transplant centers who had received organ transplants with microbiological confirmation of influenza A H1N1 infection from April to December 2009.

The researchers found that 167 of 237 patients (71 percent) were admitted to the hospital. Of 230 patients with data available on complications, 73 (32 percent) experienced pneumonia, 37 (16 percent) were admitted to an ICU, and 10 patients (4 percent) died. Antiviral drug therapy was administered to 223 patients (94 percent). Seven of the patients (8 percent) given the drug therapy within 48 hours of symptom onset were admitted to an ICU, compared with 28 of the patients (22.4 percent) given antiviral therapy at a later time. Although the rates of hospital and ICU admissions were similar among adults and children, children who received transplants were less likely to present with pneumonia than adults.

"The most important finding was that starting antiviral treatment within 48 hours of symptom onset was associated with a decrease in admission to hospital and ICU, need for mechanical ventilation, and death," the authors write. "This finding was consistent across many related outcome measures and reinforces the importance of early treatment with antiviral drugs in this susceptible population."